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Topic: I could really use some advice. Please and thank you (Read 872 times)

Before I dive into my situation, I will give you a brief background about myself and my issues. I am a 21 year old college student and my obsessive health thoughts started about May 2013. I have always been extremely health conscious (as well as a perfectionist in many regards) and during finals week I was cramming for finals and decided to take someone else's adderall and also consumed caffeine. That evening my heart rate was at 150 and would not go down. I felt dizzy, terrible chest pain, my left arm was numb, was pale, and couldn't differentiate between whether it was just a panic attack from all of my anxiety or an actual heart attack. So I called 911 (campus police took me) and was rushed to the ER. Upon arrival, they took my blood pressure, pulse, and all of the other basic diagnostic tests which made me realize that it probably wasn't too severe. The doctor in the ER hooked me up to an EKG for 45 minutes and did a few other tests and everything was absolutely fine. He sat me down and talked about how I made a bad decision and how hypochondria leads to a majority of unnecessary hospitalizations. Upon hearing this, I felt immediately better and stopped thinking about my issues. Several weeks later, I developed a persistent headache and became convinced that I had a brain tumor. Over the course of these past 13 months, I have probably "had" 10 or so life threatening illnesses that I was absolutely convinced that I had. This week it was colon cancer and now I have been having a heart attack obsession for four days. I realized that I finally need help and cannot manage this on my own anymore without going insane. I saw a therapist for several weeks a few months ago and it wasn't beneficial. My therapist merely reiterated much of the things I already knew and was more interested in trying to tell me that I am pursuing the wrong things in life (money and power). I think some of my issues might be do to the incredibly high expectations I place upon myself and what I plan on accomplishing. Thus, I talked to my parents today about me seeing a psychologist specialized in CBT, but my parents are reluctant to pay for it because they think that I will merely manipulate the therapist during the session and then right after go back to my obsessive thoughts. This issue is slowly ruining my relationship with my parents and my dad has even suggested that I be hospitalized for it. I truly want to resolve this issue, but based on my lousy experience with one particular therapist, I am kind of reluctant to start with another, especially considering that my parents have little faith in the effectiveness of it for me. My doctor has prescribed me xanax for emergency situations, but I want a long term solution to this problem. I have tried to eradicate the need for constant reassurance, but I find myself being drawn right back into it. I spent money on justanswer and waisted a cardiologist's time to hear what my parents have been constantly telling me - which is that I am completely healthy. I have had half a dozen tests done in the last year and every single one has passed with flying colors, but for some reason this just won't convince me that I am perfectly healthy.

Sorry if this wasn't really a question, I just needed to go on a tangent and let my thoughts to be heard. Feedback will be much appreciated. Thanks in advance

What about family therapy? Maybe a few sessions with your parents sitting in so that they can better understand the severity of the problem and your willingness for help?

I'm confused that your parents would rather hospitalize you than let you see a doctor.

At this point, though, perhaps going into a hospital isn't a bad idea, as you will see a psychiatrist there and then that doctor can educate your parents about your condition. Just a thought, being that your parents don't seem to want to do it any other way.

I haven't considered that, but I think it could be possibility. My dad is a psychiatrist and has said that I need to see someone specializing in CBT. So I am taking the LSAT in September and I need to score in the 90th-95th percentile on it while maintaining my 4.0 GPA and my parents think that a lot of my problems are merely an excuse that I can use if I do not accomplish these goals. I have found my obsessions becoming progressively worse and I think part of the reasoning behind the hospitalization is just so they can get me out of the house since I am negatively impacting their work and lives. I also think that my ever increasing desire for reassurance is contributing to their decision. When I sit down and logically think through it, I can totally understand why they are so frustrated with me because I have all of the medical evidence in the world to show that I am healthy, but I just can't accept it.

They were adamant about me seeing a psychologist several months ago, but I just didn't have the time to do it, so I don't really understand why they don't think I will achieve any meaningful results from seeing a psychologist now.

It has just gotten to the point where I am hypersensitive about every bodily sensation:

If I have a headache, my first thought is a brain tumor.If i have chest pain/discomfort, my first thought is a heart attack. If I trip, my first thought is ALS.If I feel a bump, then it's lymphoma. If I am more tired than usual, then it's leukemia. the list goes on...

Your father is a psychiatrist? I'm shocked that he doesn't recognize that you have an anxiety disorder, but rather they feel you are doing it to get out of other obligations relating to school.

Perhaps your parents are in denial. It happens. I'm sorry you don't have their support...

You have ours here. I think eventually your parents will come around....hopefully soon.

I'm not a doctor....but from what you described I'm thinking Health Anxiety/Hypochondria? ( I do not have either of those so I could be wrong, I'm not sure what the difference between HA and Hypochondria is to be clear).

I'm of the opinion that HA isn't a disorder on its own, but a symptom of one, such as OCD or GAD. The reason I feel its important to make this distinction is because it's more of the underlying thought process that is important to examine instead of the symptom. For example, if your problem is OCD, you might be deathly afraid of leaving the stove on and burning your house down. You develop a compulsive checking habit and it fuels your obsession that you might burn the house down. As your anxiety grows and grows by feeding it through your checking behaviors, you begin to doubt more and more if you've indeed left the stove on, because that's how the anxious mind works. After a certain point, reassurance and checking does not alleviate anxiety anymore but the brain believes that it is better than nothing and thus is helping.

But extend that situation to health anxiety. You are deathly afraid of getting a heart attack and as a result you are constantly checking aspects of your heart health to make sure that you're okay. You'll check things on google to get reassurance that you won't die of a heart attack. You'll check with doctors. You'll check with other people. You'll check the statistics. "Only .02% of people under 30 die of heart attacks (made up statistics)? Well I bet those .02% never thought they'd die from a heart attack at my age either!" Your mind focuses on the chance it might be you, and not the 99.98% chance it isn't you. Your constant checking and seeking of reassurance only serves to deepen the anxiety and obsession.

Both two different situations, superficially, but the underlying unhealthy thought process is the same. You have some sort of uncertainty/doubt/anxiety/fear, you respond to that fear with checking/reassurance/coping of some kind to try and make anxiety go away, your brain thinks these things are helping you so it allows your obsessive thoughts about the subject to grow and grow and grow. All the while, this cycle is making you more and more anxious and the reassurance behaviors become more and more futile.

It is absolutely tough and time consuming to be in that state of mind.

I have been diagnosed with OCD, so I can say for sure that my HA is related to OCD...but I don't know if that applies to everyone who has HA. All I know is that the way people with HA behave is extremely similar to OCD in almost all case I've read, so I believe the same general advice is beneficial to anyone with HA.

What has helped me immensely with all forms of anxiety, including HA is this.

1. Learn to accept uncertainty and learn to live with imperfection

-It seems that many people with HA can have perfectionist tendencies and so they want to know that they are perfectly healthy and free of health problems before they feel they can move on and live a happy life. Additionally, there is a huge desire to want to KNOW for SURE that you are okay before you feel you can move on and do other things. This is part of the disorder. The reality in life is that there is never any certainty ANYWHERE. There are different degrees of certainty, but what an anxious mind usually wants is complete reassurance that nothing bad is happening. What makes this a disorder is the "complete reassurance" part. Part of the disorder is the mind's amazing ability to doubt everything. If your mind can pick at a tiny detail that doesn't fully seem to explain something, your mind will amplify that and begin to doubt that you are okay even in the slightest bit. Your mind will ALWAYS find something to question or doubt.

You must learn to embrace when you simply do not know what is going on and you do not know what will happen. This is very scary to admit at first. You will feel a loss of control and an increase in anxiety for maybe minutes, hours, or even days. If you want to break out of the anxiety loop, you have to become friends with uncertainty. You have to learn to embrace the anxiety, which takes time to get good at. To eventually experience less anxiety in general, first you have to experience more of it.

2. Completely stop checking/reassuring/coping behaviors

This is equally as important as the first step. In response to anxiety, you might google symptoms, call your doctor immediately, contact them frequently about different questions or maybe repeat the same questions, talk to your family members about the same subject frequently, seek reassurance from people around you that you are okay, monitor your body very closely, check things in the mirror, checking your pulse to see if it is normal, googling normal numbers, googling heart attack cases to see if they match up with you, etc.

These behaviors might be reassuring AT FIRST. Left long enough, however, they will begin to consume you and allow your anxiety to grow about a problem that you should already have moved on from to continue for a long period of time. Eventually, your mind will find problems and faults with ny form of reassurance. "How does that person know i'll be okay? Did my doctor check enough? What if he was being careless? What about that guy on the internet who died from a heart attack at 19?! Okay, three sites told me i'm probably fine, i'll try and find another site just to be completely safe."

This is where ERP therapy (exposure and response prevention) comes in really handy. You gradually expose yourself to your fears and anxieties, and you make every effort not to give into those anxieties with a coping/checking/reassurance behavior. It's extremely tempting, but if you can remain resilient, you have taken major steps into living a more anxiety-free life.

3. Start with small anxieties and work your way up.

If you have tons of anxieties or are anxious about other things, it might be helpful to cut out one compulsive behavior at a time. Maybe it is too much to stop asking for reassurance for everything. Perhaps you are only slightly afraid of one thing but absolutely terrified of another thing. Start by not checking on the smaller problem that you would feel more able to handle.

The point of this step is that if you have massive anxiety, generally doing the things you need to do which will ultimately bring you to peace of mind will require big jumps in anxiety. If you have too much, this can be too frightening and you might be too scared to move forward, or cause harm to yourself in one way or another (googling binge for example...now you know too much and will never be able to rest!)

4. When it comes to therapy, you have to kiss a lot of frogs before you find your prince/princess.

Hardly anyone likes the first therapist they go to see, especially if they are uncomfortable with the idea of therapy in general. Therapy is a perfectly useful tool that all types of people benefit from. Many seemingly normal people on the outside go to therapists, and many people who don't really have diagnosable mental health issues also see therapists. Everyone has mental health, even if one doesn't have a specific disorder, and anyone can use it to help take care of their mental health.

Likely, you will have to try a few therapists before you find someone you like and trust. The therapists know this too. When they are in there doing your intake, that is just as much of an opportunity to ask questions of them. You are both feeling each other out to see if it is a good fit. They get that. It's not offensive if you thank them for their time but you don't feel its a good fit. Mention from the beginning that you are still in the process of finding the right therapist and you will find they totally understand.

Don't let one off therapy session ruin all of therapy for you, it can be really helpful to work with someone you trust on these issues. They can help troubleshoot any problems along your path to recovery, as well.

I hope this was helpful. It really sucks to be so focused on health for no reason. I promise you it will be so worth it when you can realize for once in your life that you are indeed healthy and enjoy life instead of worrying about what may happen around the corner (that usually never does happen).

Thanks for posting this. As one with OCD, GAD and Agora, I never had even heard of HA before until recently.... and like you, it certainly does sound like a symptom of OCD or GAD. Very valid points in this post. Very informative.

I have one more thing I wanted to add in reference to one of cameronj's statements in the OP.

Quote

I have tried to eradicate the need for constant reassurance, but I find myself being drawn right back into it. I spent money on justanswer and waisted a cardiologist's time to hear what my parents have been constantly telling me - which is that I am completely healthy. I have had half a dozen tests done in the last year and every single one has passed with flying colors, but for some reason this just won't convince me that I am perfectly healthy.

Your HA will NEVER be convinced that you are okay. It will never feel reassured, it will never feel fine and safe. The point is not to search for those feelings of safety and being convinced that you are okay. That is part of the disorder. You're not doing it to make yourself realize you don't have a heart problem logically. All signs point to the fact that you don't at all, but you can never truly know. This is what keeps the disorder going. The desire for complete certainty.

Don't chase after feelings of being okay. That's why you google and that's why you check with doctors. But it doesn't work. You need to be able to learn to sit with being uncomfortable and uncertain. At a certain point, you might feel a switch in your brain go off and you realize that you were worrying about nothing. Until then though, don't stress out about not feeling okay, that's part of the recovery process. You'll be feeling uneasy about your health for no reason for a while.

The goal is NOT to appease HA and make it feel safe, it's to break out of that need for feeling safe.

I can relate of course, with OCD ...sometimes being called the Doubters Disorder.

Years ago when my OCD was extreme, no matter how many times I checked the stove, I had to go back and check again....just to be sure it was actually off ...At one point years ago ...I even asked a friend to check. I was never totally convinced until I literally checked so much I was sweating.

At that point I was sick and tired of it. I went on meds but before they kicked in- I decided to try a different tactic ....

When I went to check the stove, I took a photo of it and walked away. *not sure if that was cheating, but, it got me down to checking once before leaving - and before the meds kicked in.

Every so often, if I feel like I want to "check the stove a second time", (or anything that I feel I might want to check) I take a photo after I check ONCE.

Tunnelvisionary, thank you for your beautifully elucidated response. I found it highly insightful and encouraging. I think number 1 and 2 are where I really need to start. I attempted to accomplish both today but it is much more difficult than i anticipated. I have never done well with uncertainty due my constant need to perfect things, so I'm thinking that a therapist could really help with that regard. I guess I just have this idealized sense of how my body should feel, when the reality is that everyone experiences hundreds of bodily sensations on a daily basis. I just choose to fixate on them and blow them out of proportion. Like today I went for a run for the first time in 15 days and shaved 2 minutes off my mile time. I experienced a decent amount of chest discomfort half way through and any rational person would most likely have attributed to it as being out of shape and running faster whereas I immediately jumped to the conclusion of a heart attack. Lone behold, I am still here and eventually realized that they were irrational. I think today was a step in the right direction though because I only had one major freak out whereas I've had multiple ones the previous 4 days. I've started taking my xanax when my anxiety gets really bad and it helps immensely but I'm not a fan of medication. The need for constant reassurance and obsession with knowledge are definitely my two major obsessions that underline all of this.

Lastly, I think my fear of death (especially an early death) is the root of my issues. All of these ailments are exacerbated by the fact that they could kill me. The ironic part is that I'm more likely to get hit by a car crossing the street or die in a collision with a drunk driver and neither one stops me from going outside or driving on the freeway. I am an atheist and I sometimes wonder if i believed in a higher power or an afterlife would ease some of my fears.